title: Double renal transplantation--a strategy with donors under 3 years old.
abstract: OBJECTIVE
  To evaluate the transplantation of both kidneys from donors under 3 years old to older pediatric recipients, in order to provide adequate renal mass and improve graft survival.
  
  
  METHODS
  Seven patients received a double kidney transplant from a donor under 3 years old (mean age 2.7 years). The primary renal disease was obstructive uropathy in two patients, and hemolytic uraemic syndrome, tuberous sclerosis, nephronoptisis, reflux nephropathy and nephrotic syndrome (one patient each). Recipients were 14-18 years old and had a mean height of 165.2 cm. Five were in dialysis and it was the second transplantation for two. Both kidneys were sequentially placed in the same iliac fossa; the first was placed the most cranially with the second placed caudal to the first. The surgical technique was similar to that used to place a single graft. Immunosuppression induction employed monoclonal antibodies followed by a triple therapeutic regime (mofetyl micofenolate/steroids/tacrolimus).
  
  
  RESULTS
  Diuresis was started immediately with all the grafts and there was no thrombosis in any patient. One patient lost both grafts due to recurrence of her primary disease. Another patient developed lymphocele 1 year post transplant and required laparoscopic drainage. The grafts in six patients are doing well after a follow up of 1 to 7 years.
  
  
  CONCLUSIONS
  Double transplant of both kidneys from a donor under 3 years old can provide sufficient renal mass for adequate renal function and does not present a higher risk of complications.
authors.affiliation: Paediatric Urology, Hospital Universitario, Po Castellana 261, La Paz, Madrid 28046, Spain. mjmu@hotmail.com
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Martinez Urrutia
authors.forename: P López
authors.initials: PL
authors.lastname: Pereira
authors.forename: L F
authors.initials: LF
authors.lastname: Avila Ramirez
authors.forename: R Lobato
authors.initials: RL
authors.lastname: Romera
authors.forename: C García
authors.initials: CG
authors.lastname: Meseguer
authors.forename: E Jaureguizar
authors.initials: EJ
authors.lastname: Monereo